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Understanding and Evaluating Proposals for Managed Long-Term Care in Medicaid

In managed long-term care, health plans receive a set payment for each person enrolled in Medicaid. If a person's health care costs are more than that set amount, the plan loses money. If the patient's costs are less than that amount, the plan keeps the extra money.

Many states see managed long-term care as a way to rein in Medicaid costs or provide greater budget certainty. But the goal of managed long-term health plans is to encourage plans to get patients the most effective care.

Advocates can use these issue briefs to learn more about how managed long-term care in Medicaid works and what questions to ask when determining whether the structure of managed care plans meets the needs of consumers.

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